Registration Form-Payment in Rupees  
 
Title
Professor Dr. Ms./Mrs. Mr.   Accompanying person
Name
Position
   Graduate student Postdoc Senior Investigator Other
Department
Institution
Street
  
City
Country
  
Zip/Postal
Telephone
  
E-mail#
Date of Arrival(d/m)
    
Date of Departure(d/m)

# mandatory field

Passport details
Passport No.
    
Date of issue
Date of expiry
    
Place of issue
 
Accomodation
 Single occupancy Double Occupancy* Triple Occupancy*

if double or triple occupancy is requested, please provide name of “preferred room mate(s)” (if you have a preference)*.
Name of the preffered room
mates/accompaning person

If you choose” double or triple occupancy” and wish to be assigned a room mate,
please indicate your gender:

 Male Female

If submitting an abstract, please check the box

 Abstract

Registration Fee: Until June 15, 2010

Ph.D Students
Post-doc, Professor, and Others
Single Room Rs. 45,000 Rs. 51,000
Double room Rs. 24,500 Rs. 31,000
Triple Room Rs. 21,500 Rs. 28,000
Extra Nights Rs. 8,000 Per single / Double room per night (breakfast and taxes inclusive) Rs. 8,500 Per single/Double room per night (breakfast and taxes inclusive)
Do not select above options if you are Non residents/Day visitors
Non residents/Day visitors Rs. 5,000 Rs. 10,000

Registration fee includes full board (dinner 23/09 - lunch 27/09) also includes accommodation from 23/09 to 27/09, i.e. 4 nights.

The prices for accompanying persons are the same as for the participants. Extra nights and pre/post-meeting travelling: please contact directly at toptrav@vsnl.com .Phone/FAX:  +91 11 25708822 / 25709228 / 25708228, fax +91 11 25701125 / 25704228
Total Payment

Rs.

  
 
 
 

Payment through Bank Transfer or Credit Card

  

Bank Transfer Details: Account name: TOP TRAVEL & TOURS (P.) LTD. Bank Account No.: 223010200013183 Swift Code: AXISINBB223
Bank name and address: AXIS BANK LTD., 6/83, PADAM SINGH ROAD, W.E.A. KAROL BAGH, NEW DELHI - 110005 (INDIA)

Purpose of payment:SMYTE28

name of delegate for whom payment is being made

Note: Under Bank Transfer, it is mandatory to mention SMYTE28 and name of delegate for whom payment is being made.

                                        

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